- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $581.94 / $3,580.75 / $8,492.29
| Facility | | $581.94 | $3,580.75 | $8,492.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.47 / $603.49 / $1,534.74
| Professional | | $269.47 | $603.49 | $1,534.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.39 / $551.39 / $1,331.18
| Professional | | $246.39 | $551.39 | $1,331.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,949.61 / $3,879.54 / $7,504.28
| Facility | | $2,949.61 | $3,879.54 | $7,504.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $421.49 / $810.22 / $1,193.83
| Professional | | $421.49 | $810.22 | $1,193.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,257.44 / $1,257.44 / $1,257.44
| Facility | | $1,257.44 | $1,257.44 | $1,257.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $571.34 / $1,040.10 / $1,620.88
| Professional | | $571.34 | $1,040.10 | $1,620.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $356.56 / $923.46 / $2,319.23
| Facility | | $356.56 | $923.46 | $2,319.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $554.54 / $998.46 / $2,523.00
| Professional | | $554.54 | $998.46 | $2,523.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.97 / $1,273.86 / $1,676.58
| Facility | | $672.97 | $1,273.86 | $1,676.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $643.98 / $1,080.72 / $1,592.83
| Professional | | $643.98 | $1,080.72 | $1,592.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $662.82 / $1,124.17 / $1,427.61
| Professional | | $662.82 | $1,124.17 | $1,427.61 |